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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 張書森 | zh_TW |
| dc.contributor.advisor | Shu-Sen Chang | en |
| dc.contributor.author | 范嘉栩 | zh_TW |
| dc.contributor.author | Stephanie Fan | en |
| dc.date.accessioned | 2026-08-28T16:36:25Z | - |
| dc.date.available | 2026-08-29 | - |
| dc.date.copyright | 2026-08-28 | - |
| dc.date.issued | 2026 | - |
| dc.date.submitted | 2026-08-17 15:10:29 | - |
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/104597 | - |
| dc.description.abstract | 前言
在臺灣，多元性別社群（Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, and Asexual, LGBTIQA+）以及其他性/別少數族群（Sexual and Gender Minority, SGM），因長期承受少數壓力與社會污名，而面臨較高的心理健康問題及自殺風險。心理健康急救（Mental Health First Aid, MHFA）是一套源自澳洲、具實證基礎的公眾教育訓練計畫，旨在提升民眾辨識心理困擾早期徵兆及提供初步協助的能力。本研究目的在於依據臺灣的社會文化脈絡，對澳洲心理健康急救支持性/別少數族群的指引進行文化調適。 研究方法 本研究於2026年在臺灣採用三回合修正式德菲法（Modified Delphi）專家共識研究，共招募三個專家小組：（1）具有服務性/別少數族群經驗的心理健康專業人員；（2）具有心理健康困擾經驗的性/別少數族群當事人；以及（3）曾支持具有心理健康困擾之性/別少數族群當事人的支持者。所有專家針對各項協助行動陳述的重要性，以五點李克特量表進行評分。共識標準預先設定為三個獨立專家小組皆有至少80%的成員評定為「非常重要（Essential）」或「重要（Important）」。第一回合的開放式意見經主題分析後，用於新增及修訂符合臺灣文化情境的條目。 研究結果 第一回合共有131位專家完成調查，包括44位心理健康專業人員、38位具有心理健康困擾經驗的性/別少數族群當事人，以及49位支持者；其中102位完成全部三個回合，整體留存率達78%。初始190項陳述中，共有148項獲得共識納入，42項遭刪除。根據第一回合的質性回饋，新增21項陳述，三回合共評估211項陳述，其中19項獲得共識納入。主要的文化調適內容包括：尊重當事人的自主性、避免以文化刻板印象看待性/別少數族群、納入臺灣家庭中「出櫃」歷程的特殊家庭互動情境，以及新增「Chemsex（藥物性愛）」專章，涵蓋其相關症狀及其與心理健康困擾的關聯。 結論 本研究完成了臺灣首套專為支持性/別少數族群所設計的文化調適版心理健康急救指引。透過心理健康專業人員、具有心理健康困擾經驗的性/別少數族群當事人，以及支持者三方的共識，確保最終指引能充分反映臺灣當代性/別少數族群的真實需求與生活經驗。未來研究應進一步評估本指引於不同人口特性及社會經濟背景學員中的實際應用成效與教育效益。 | zh_TW |
| dc.description.abstract | Introduction
In Taiwan, Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, and Asexual (LGBTIQA+), or Sexual Gender Minority (SGM), individuals experience elevated risks of developing mental health challenges and suicidality due to chronic minority stress and social stigma. Mental Health First Aid (MHFA) is an evidence-based public education program developed in Australia designed to equip the public with skills to identify early signs of mental distress and provide initial support. This study aims to culturally adapt the Australian MHFA guidelines for supporting an SGM person to align with the Taiwanese sociocultural context. Methods A three-round Modified Delphi expert consensus study was conducted in Taiwan in 2026. Three panels of experts were recruited, consisting of: (1) Mental Health Professionals (MHP) with experience working with SGM individuals; (2) SGM individuals with lived experience of mental health challenges (SGM-LE); and (3) individuals who support SGM individuals with lived experience (support person, SP). Panelists rated potential helping action statements on a 5-point Likert scale regarding their importance. Consensus was predefined as >= 80 endorsement as "Essential" or "Important" across all three independent panels. Round 1 qualitative feedback was coded to generate and refine context-specific items. Results Round 1 was completed by 131 experts (44 MHP, 38 SGM-LE, 49 SP), with 102 experts completing all three rounds, demonstrating a robust overall retention rate of 78%. Out of the initial 190 statements, 148 were endorsed and 42 were rejected. 21 new statements were added, resulting in a total of 211 items rated across three rounds. 19 of the 21 new statements were endorsed. Key adaptations primarily concentrated on respecting autonomy, rejecting cultural preconceptions, recognizing unique family dynamics of "coming out" within Taiwanese households, and introducing a new section on "Chemsex", its symptoms and its association with mental health distress. Conclusion This study presents the first culturally adapted MHFA guidelines specifically tailored for supporting SGM individuals in Taiwan. The distinct multi-perspective agreement among MHP, SGM-LE, and SP successfully anchors the final guidelines in the contemporary lived realities of the local community. Future research should systematically evaluate the practical implementation and educational outcomes of these guidelines across trainees of diverse demographic groups and socio-economic backgrounds in Taiwan. | en |
| dc.description.provenance | Submitted by admin ntu (admin@lib.ntu.edu.tw) on 2026-08-28T16:36:25Z No. of bitstreams: 0 | en |
| dc.description.provenance | Made available in DSpace on 2026-08-28T16:36:25Z (GMT). No. of bitstreams: 0 | en |
| dc.description.tableofcontents | MASTER’S THESIS (DOCTORAL DISSERTATION) ACCEPTANCE CERTIFICATE i
Acknowledgements ii Abstract & Keywords (Chinese) iii Table of Contents vii Chapter 1: Introduction 10 1.1 Sexual and Gender Minority (SGM) Mental Health 10 1.2 Barriers and Challenges in Mental Health Care for SGM in Taiwan 11 1.3 Mental Health First Aid (MHFA) 13 1.4 Cultural adaptation of interventions and guidelines 16 1.5 Study Aims 17 Chapter 2: Literature Review 18 2.1 Cultural Adaptation of Mental Health Interventions 18 2.2 Conceptual Frameworks of Cultural Adaptation 20 2.3 Methods of Cultural Adaptation 21 2.4 Cultural adaptation of MHFA using the Delphi Method 23 2.5 Need for Cultural Adaptation of MHFA for SGM Individuals in Taiwan 26 Chapter 3: Methods 27 3.1 Overview of the Current MHFA LGBTIQ+ Guidelines 27 3.2 Overview of the Delphi Method 28 3.3 Panel Selection and Recruitment 29 3.3.1 Participant Eligibility (Inclusion and Exclusion Criteria) 29 3.3.2 Recruitment Strategy 30 3.3.3 Panel Size and Attrition Management 31 3.4 Questionnaire Development 32 3.4.1 Source Consolidation 33 3.4.2 Removing Duplicates, Adolescent-Focused Items, and Irrelevant Items 35 3.4.4 Items Generated from the Basic Literature Search 37 3.5 Delphi Procedure and Data Collection 41 3.6 Data Analysis 43 3.6.1 Quantitative Statistical Analyses 43 3.6.2 Qualitative Data Analyses 45 3.6.3 Ethical Considerations & Researcher Positionality 46 3.6.4 Researcher Positionality 46 Chapter 4: Results 48 4.1 Participant Numbers and Characteristics 48 4.1.1 Mental Health Professional Panel Characteristics 51 4.1.2 SGM Lived Experience Panel Characteristics 52 4.1.2 Caregiver and Support Person Panel Characteristics 53 4.2 Rating of Statements 54 4.3 Consensus within Expert Panels Across Three Rounds 56 4.4 Differences between the guidelines for Taiwan and Australia 57 Chapter 5: Discussion 58 5.1 Overview of findings 58 5.2 Comparison with the Australian Guidelines 58 5.2.1 Discrepancies in Rejected Items between Taiwan and Australia 63 5.3 Consensus Dispersion Across Three Panels 64 5.4 Key Domains in the Cultural Adaptation in Taiwan 65 5.4.1 Recognition of the Broader Social and Interpersonal Context 65 5.4.2 Structural Awareness and Role-Appropriate MHFA 66 5.4.3 Chemsex 68 5.5 Implications 69 5.6 Strengths 71 5.7 Limitations 71 5.8 Conclusions 74 References 75 Figures 86 Figure 1. Summary of Source Consolidation Process 86 Figure 2. Summary of Cross-Referencing Process 87 Figure 3. Summary of Literature Search 88 Figure 4. Delphi Study Timeline 89 Figure 5. Flowchart of Round 1 Recruitment 90 Figure 6. Flowchart of Survey Items Endorsed, Rejected, and Re-Rated 91 Tables 92 Table 1. MHFA LGBTIQ+ Appendix Section Summary 92 Table 2. Summary of Initial Translation Modification Items 93 Table 3. Final Items Included from Literature Search 94 Table 4. Glossary Feedback Items 95 Table 5. Round 1 Initial Survey Sections and Number of Items 96 Table 6. Characteristics of Delphi Participants 97 Table 7. Participant Numbers Across Three Survey Rounds 99 Table 8. Mental Health Professional Panel Characteristics 100 Table 9. SGM Lived Experience Panel Characteristics 101 Table 10. Caregiver and Support Person Panel Characteristics 102 Table 11. Expert Panel Consensus Dispersion Across Three Rounds 103 Table 12. Summary of Newly Added Items 104 Appendix 1. Full Questionnaire Across Three Delphi Rounds 108 德菲法問卷: 第一輪 108 研究參與者知情同意書：德菲法研究參與者 108 第二節: 名詞定義 117 第三節: 德菲法問卷 119 德菲法問卷: 第二輪 186 (一) 提供心理健康急救給多元性別社群所需的一般認知 186 (二) 與多元性別社群的溝通 189 (三) 揭露與出櫃經驗 203 (四) 情緒困擾、心理健康問題與危機狀況 215 (五) 尋求心理健康問題的協助與支持 224 (六) 名詞定義 227 (七) 藥愛 228 德菲法問卷: 第三輪 231 (一) 提供心理健康急救給多元性別社群所需的一般認知 231 (二) 與多元性別社群的溝通 232 (三) 揭露與出櫃經驗 235 (四) 情緒困擾、心理健康問題與危機狀況 237 (五) 尋求心理健康問題的協助與支持 239 (六) 名詞定義 240 (七) 藥愛 240 Appendix 2. Statement Categorization 242 | - |
| dc.language.iso | en | - |
| dc.subject | 心理健康急救 | - |
| dc.subject | 臺灣 | - |
| dc.subject | 德菲法研究 | - |
| dc.subject | 文化調適 | - |
| dc.subject | 性別與性傾向少數 | - |
| dc.subject | 多元性別社群 | - |
| dc.subject | 藥愛 | - |
| dc.subject | Mental Health First Aid | - |
| dc.subject | Taiwan | - |
| dc.subject | Delphi Method Study | - |
| dc.subject | Cultural Adaptation | - |
| dc.subject | Sexual Gender Minority | - |
| dc.subject | LGBTIQ+ | - |
| dc.subject | Chemsex | - |
| dc.title | 臺灣性/別少數族群心理健康急救指引之文化調適:德菲法研究 | zh_TW |
| dc.title | Cultural Adaptation of Mental Health First Aid Guidelines for Sexual and Gender Minority Individuals in Taiwan: A Delphi Study | en |
| dc.type | Thesis | - |
| dc.date.schoolyear | 114-2 | - |
| dc.description.degree | 碩士 | - |
| dc.contributor.coadvisor | 李柏翰 | zh_TW |
| dc.contributor.coadvisor | Po-Han Lee | en |
| dc.contributor.oralexamcommittee | 王雅青;張齡尹 | zh_TW |
| dc.contributor.oralexamcommittee | Ya-Ching Wang;Ling-Yin Chang | en |
| dc.subject.keyword | 心理健康急救; 臺灣; 德菲法研究; 文化調適; 性別與性傾向少數; 多元性別社群; 藥愛 | zh_TW |
| dc.subject.keyword | Mental Health First Aid; Taiwan; Delphi Method Study; Cultural Adaptation; Sexual Gender Minority; LGBTIQ+; Chemsex | en |
| dc.relation.page | 264 | - |
| dc.identifier.doi | 10.6342/NTU202604355 | - |
| dc.rights.note | 同意授權(全球公開) | - |
| dc.date.accepted | 2026-08-17 | - |
| dc.contributor.author-college | 公共衛生學院 | - |
| dc.contributor.author-dept | 全球衛生學位學程 | - |
| dc.date.embargo-lift | 2026-08-29 | - |
| 顯示於系所單位： | 全球衛生學位學程 | |
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